The controversy over dietary fats began in the 1940s when research started to link high cholesterol with heart disease. High dietary fat was blamed for high cholesterol, and many people avoided all fatty foods – even those that are health-promoting – for decades.

We now understand the relationship between dietary fat intake and cardiovascular disease is not linear and inflammation is an important factor. While trans-fatty acids should be minimized, ironically, excluding healthy fatty acids from our diets in favor of low-fat, high carbohydrate alternatives promotes higher levels of systemic inflammation. Including the right types of fats and avoiding others can decrease inflammation.

Saturated fat has been controversial and while it is true that high dietary intake of even healthy saturated fats like MCTs in coconut oil or those in grass fed meats may raise your LDL (“bad”), that increase is seen in the less inflammatory LDL and has not been associated with an increase in mortality. Healthy saturated fats also raise HDL (“good”) cholesterol. Appetite control can be another benefit of including clean saturated fat in your diet.

Types of essential fatty acids. There are two main classes of essential fatty acids – omega-3s and omega-6s. “Essential” means these nutrients are something our bodies require but cannot synthesize. Research suggests that maintaining a favorable ratio between omega-3s and omega-6s can reduce systemic inflammation. Omega-6s are not unhealthy per se, but modern diets contain excessive amounts. To improve the ratio, reduce your intake of omega-6-containing oils such as corn, sunflower, safflower and soybean (common in processed and restaurant foods) while adding dietary sources of omega-3s.

Eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA) are the primary forms of omega-3s fatty acids. EPA reduces cellular inflammation and neuro-inflammation, which are associated with chronic conditions as diverse as dementia and fibromyalgia. DHA helps increase the protective (“good”) cholesterol HDL and decreases triglycerides. It also protects your telomeres which are important for anti-aging. ALA is found in plants and must be converted to be active in the body.

Good sources of omega-3s. Dietary sources of omega-3s are preferred to supplements which do not permeate vital tissues in the way that whole food sources can. In fact, taking omega-3 supplements does not guarantee that you do not have a fatty acid deficiency. Recommended daily amounts of omega-3s vary depending on your situation; however, two servings of fatty fish per week are a good baseline. Include fish from the SMASH group (Salmon, Mackerel, Anchovies, Sardines and Herring) as they are generally lower in toxins and higher in omega-3s. Oysters contain omega-3s; fish roe and cod liver are also convenient sources.

Avoid farmed fish as they are often fed grain-based feeds that promote omega-6 fatty acid content over omega-3. Likewise, the type of feed livestock consume determines the fatty acid content of meat. Cows raised on grain-based feed (containing mostly corn and soy) produce beef, milk and cheese that has a high ratio of omega-6 to omega-3. If cows are grass-fed, they produce beef and dairy products rich in omega-3 fatty acids. Similarly, eggs can contain significant amounts of omega-3s if raised on specialized feed.

Examples of plant-based sources of omega-3s include chia seeds, pumpkin seeds or pepitas, walnuts, hemp hearts, flaxseeds and macadamia nuts. Algal oil has also emerged as a reliable vegan source of DHA and EPA. Keep in mind that plant-based sources of omega-3s provide ALA that must be converted in the body. This process is inefficient, so while these are great whole foods, it is difficult to consume sufficient amounts of plant-based omega-3s to meet daily requirements.

Monounsaturated fats (MUFAs) are another class of health-promoting fatty acids. MUFAs are most notably found in olive oil and are associated with improved LDL and HDL profiles, providing some of the well-known cardiovascular benefits of the Mediterranean diet. Other sources of MUFAs include olives, avocados, almonds, cashews and pecans.

Cooking with oils. Cooking with oils and fats imparts flavor and taste. However, overheating them causes damage, and consuming heat damaged fats promotes inflammation. The smoke point is the temperature at which an oil can become damaged. Avocado oil, coconut oil and ghee are safe options for grilling or baking with high heat. Olive oil’s smoke point varies based on how refined it is. Extra virgin olive oil is best for drizzling onto foods after cooked; more refined or light olive oils have higher smoke points and are more suitable for grilling and frying.

Lastly, remember when increasing dietary fats, it is important to cut refined carbohydrates and sugar from your diet at the same time. The benefits of adding healthy fats can be offset by an imbalance in your microbiome if you don’t have the antioxidants and nutrients from plenty of fresh vegetables and fruits to keep your entire system in balance.

Dr. Wheeler is a board-certified family medicine physician with Riverside-San Bernardino Indian Health in Thermal. She is certified through the Institute of Functional Medicine and is available for functional medicine consults through Restore Health in Indian Wells. For more information visit www.RestoreHealth.me or call (760) 898.9663.